MEDICARE: PROJECT ENCOMPASS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1164384202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROJECT ENCOMPASS INC.

Provider Business Mailing Address
First Line	:	9832 LYON AVE
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-1722
Country	:	US
Telephone Number	:	678-635-6124
Fax Number	:	866-703-4593

Provider Business Practice Location Address
First Line	:	9832 LYON AVE
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-1722
Country	:	US
Telephone Number	:	678-635-6124
Fax Number	:	866-703-4593

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CLARYN LYDELE BURNETT
Credential	:
Telephone Number	:	678-635-6124

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	11/26/2025

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